Ready to act on healthcare

LAST WEEK, President Obama took a bold step on healthcare: He brought together a wide array of people who have a stake in the healthcare system with the people who have the ability to change it.

Some have suggested that we should put off fixing the system because times are tough; that we can't afford to tackle healthcare until we fix the economy. The reality is that if we want to fix the economy, we can't afford not to tackle healthcare.

As the president said in his opening remarks Thursday, "Healthcare reform is no longer just a moral imperative, it is a fiscal imperative. If we want to create jobs and rebuild our economy, then we must address the crushing cost of healthcare this year, in this administration."

Exploding costs are bankrupting families and burdening businesses, dragging down state and local budgets, and piling up our national debt. The time to act is now.

Reform won't be easy. Obama acknowledged that his predecessors - beginning with President Teddy Roosevelt - had tried unsuccessfully to tackle this issue. But he also offered his belief that this time it will be different: "This time, there is no debate about whether all Americans should have quality, affordable healthcare - the only question is how."

As a participant in the 1993-'94 health reform effort, I can say that this time, it feels different already.

Thursday's forum participants came from all sides of the debate. They were Democrats and Republicans; members of Congress and constituents; businesses and labor unions; hospitals, doctors, patients, and insurance companies. People who worked to pass healthcare reform a decade ago strategized with those who worked to defeat it. And while they certainly didn't all agree on every aspect of how to fix the system, they all agreed that the one thing we cannot do is continue on the current course.

Fifteen years ago, many felt that if they couldn't have exactly the change they wanted, their second choice was no change at all. Last week, there were no defenders of the status quo. More than one Republican member of Congress agreed with the principles the president laid out for reform. Even a representative of the insurance companies that famously played such a huge role in killing reform in the 1990s pledged the industry's cooperation this time around.

In the past month alone, there has been important progress toward the goal of providing affordable, high-quality healthcare to all Americans. The children's health bill the president signed provides and protects coverage for 11 million children, while the Recovery Act ensures that 7 million men and women who have lost their jobs through this recession can keep their insurance. It also made critical investments in electronic medical records, prevention programs, and funding for research on the effectiveness of care.

But there is much more work left to do. That's why we held the forum on Thursday. It's why we opened it up to the American people by live-streaming the discussions on the Web and why we'll hold similar forums all over the country. And it's why the president has submitted a budget that sets aside a $634 billion down payment on health reform that is fully paid for and does not add one penny to the deficit.

With a focus on cutting costs, expanding coverage, and improving the quality of healthcare, and with the new sense of urgency across the spectrum, as Senator Kennedy said on Thursday, "this time we will not fail."

Nancy-Ann DeParle is director of the White House Office for Health Reform.